Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Hawaii (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Pacific Coast Medical Inc (NPI 1841318128)

Field	Value
Entity Type	Organization
Organization	Pacific Coast Medical Inc
Address	1229 Young St
City	Honolulu
State	HI
ZIP	96814
Taxonomy	Otolaryngology Physician
NPI Enumerated	March 26, 2007

Payer Source	Total Paid
Medicaid	$285.8K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	2,970	$80	$228.5K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	340	$100	$32.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	140	$120	$17.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	100	$80	$7.1K
S9999	Sales tax	30	$1	$30

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.

Claims Volume vs. Hawaii Distribution

Pacific Coast Medical Inc — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	534	710	650	$90	$274.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	128	690	650	$90	$235.4K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	14	30	140	$120	$48.5K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	7	20	170	$90	$32K
S9999	Sales tax	194	240	200	$1	$820

Nearby Providers

Other providers in the same ZIP code as Pacific Coast Medical Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Walgreen Co	HI	Pharmacy	$0	$25.3M
Mastercare Inc	HI	Nursing Care Agency	$0	$10.8M
Attention Plus Private Nursing, Inc.	HI	Nursing Care Agency	$0	$7.7M
Heaven's Helpers, Inc.	HI	In Home Supportive Care Agency	$0	$4.5M
Heaven's Helpers, Inc.	HI	Nursing Care Agency	$0	$4M
Honolulu Imaging Center, LLC	HI	Diagnostic Radiology Physician	$2.6M	$1.1M
Eugene W M Ng Md LLC	HI	Ophthalmology Physician	$0	$3.7M
Bayada Home Care	HI	In Home Supportive Care Agency	$0	$3.6M
B Homecare L.L.C.	HI	In Home Supportive Care Agency	$0	$3.5M
Hawaii Diagnostic Radiology Services LLC	HI	Diagnostic Radiology Physician	$0	$3.2M

Pacific Coast Medical Inc — Billing Profile & Reimbursement Data

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Pacific Coast Medical Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References